Mary Struble Brunk, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

16703 Issued in TX

Practice address

6805 Hillcrest Ave
Suite 218
Dallas, TX 75205-1396

Phone

(214) 750-4901

Fax

(214) 750-7408

NPI assigned

Sep 24, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mary Martha Struble Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Andrew W Randall DDS & Assoicates, PC

  • Dentist
  • Dallas, TX
  • NPI 1063746006
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083714562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 WESTMINSTER AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752051210",
            "telephone_number": "214-361-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 HILLCREST AVE",
            "address_2": "SUITE 218",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752051396",
            "telephone_number": "214-750-4901",
            "fax_number": "214-750-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNK",
        "first_name": "MARY",
        "middle_name": "STRUBLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "16703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "STRUBLE",
            "middle_name": "MARTHA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nikola DO Brunelle-Tran, PT
• Amanda Bruner, LPC-A
• Kaylah Bruner
• David W. Brunett, MD
• Sean Brunier, LMFT
• Elizabeth Shea Brunner, MD
• Robert J Brunner, MD
• Tokishia M Bruno-Garza
• Andre Russowsky Brunoni
• Brandon R Bruns, M.D.

• Dentist in Dallas, TX
• Providers in Dallas, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.